Pathologic response to neoadjuvant chemotherapy in HPV-associated oropharynx cancer
Pathologic response to neoadjuvant chemotherapy in HPV-associated oropharynx cancer
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DOI：
10.1002/hed.26022
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发表时间：
2019-11-27
影响因子：
2.9
通讯作者：
Siegel, Robert
中科院分区：
文献类型：
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作者：
Sadeghi, Nader;Khalife, Sarah;Siegel, Robert
背景 范式转变导致 HPV 阳性口咽癌 (OPC) 治疗试验逐步降级。本研究的目的是评估影像学肿瘤体积缩小预测 HPV 阳性 OPC 患者对新辅助化疗病理反应的能力。方法 对 54 例 HPV 阳性 OPC 患者进行一项前瞻性观察研究，纳入新辅助化疗随后手术的临床试验。患者接受三个周期的诱导化疗（顺铂/多西他赛）；获得化疗前和化疗后成像。使用接受者操作特征曲线和逻辑回归分析。结果 原发部位和淋巴结部位的完全病理缓解 (pCR) 率分别为 72% 和 57%。诱导化疗后肿瘤体积缩小≥90%，预测原发肿瘤的 pCR。结论 新辅助化疗后行根治性经口手术是一种值得进一步研究的新范例，MRI 是评估术前反应的可靠方法。
Background A paradigm shift has led to de-escalation trials for the treatment of HPV-positive oropharynx cancer (OPC). The objective of this study was to assess the ability of tumor volume reduction on imaging to predict pathological response to neoadjuvant chemotherapy in patients with HPV-positive OPC. Methods A prospective observational study of 54 patients with HPV-positive OPC enrolled in a clinical trial of neoadjuvant chemotherapy followed by surgery was performed. Patients underwent three cycles of induction chemotherapy (cisplatin/docetaxel); prechemotherapy and postchemotherapy imaging were obtained. Receiver operating characteristic curves and logistic regression analyses were used. Results The complete pathologic response (pCR) rate at primary and nodal sites were 72% and 57%, respectively. Tumor volume reduction of >= 90% following induction chemotherapy predicted pCR of the primary tumor. Conclusions Neoadjuvant chemotherapy followed by definitive transoral surgery is a new paradigm worthy of further investigation and MRI is a reliable modality to assess preoperative response.